江苏地区静脉吸毒人群丙型肝炎病毒基因型分布研究

Distribution of hepatitis C virus genotypes among intravenous drug users in Jiangsu Province

目的丙型肝炎病毒(hepatitis C virus,HCV)基因组呈高度的可变性和异源性,分为多种基因型和亚型。了解局部地区HCV基因型分布特点,可为丙型肝炎的诊断、预防、个体化治疗及制备不同基因型HCV疫苗提供依据。文中对南京市强制戒毒所提供的静脉吸毒人群抗HCV抗体阳性血清进行HCV常见基因型分型检测。方法用荧光定量聚合酶链反应(fluorescent quantitative-polymerase chain reaction,FQ-PCR)对552份抗HCV阳性的吸毒人员血清进行HCV RNA检测,根据国际公认的Simmonds HCV基因命名系统,依据HCV核心区序列设计1a、1b、2a、2b、3a型特异性引物,用逆转录聚合酶链反应(reverse transcription-PCR,RT-PCR)和型特异性引物对259份HCV RNA阳性的血清标本进行HCV基因分型。结果 552份抗HCV阳性血清中,有259份为HCVRNA阳性。男性和女性HCV感染者的HCV基因型总体分布、1b型感染和非1b型感染的分布差异均有统计学意义(P=0.017,P=0.034)。不同年龄段各组HCV基因型的分布差异无统计学意义;丙氨酸氨基转移酶(alanine aminotransferase,ALT)>40 U/L和ALT≤40 U/U2组人群HCV基因型分布差异无统计学意义(P=0.06)。结论江苏地区吸毒人群中HCV感染者的HCV基因型以1b型为主,其次为1b/2a型混和感染。其他多种基因型均有检出,总体分布特点介于中国南方和北方之间。

Objective Hepatitis C virus(HCV) genome has a high variability and heterology and includes a number of genotypes and subtypes.An insight into the local distribution of HCV genotypes may provide the basis for the diagnosis,prevention and individualized treatment of HCV infection as well as for the preparation of different vaccines.Our study is to investigate the distribution of HCV genotypes among intravenous drug users(IDUs) in Jiangsu province.Methods A total of 552 anti-HCV positive serum samples from drug users were subjected to HCV RNA detection by EQ-PCR,and the genotypes of HCV were determined using 1a,1b,2a,2b and 3a specific primers deduced from the core region of HCV RNA by RT-PCR.Results Of the 552 samples,259 were HCV RNA positive.Statistically significant differences were found in HCV genotypes distribution between male and female patients(P=0.017),as well as between the 1b type and non-1b type(P=0.034),but not among different age groups,nor between those with ALT > 40 U/L and those with ALT ≤ 40 U/L(P=0.06).Conclusion The predominant genotype of HCV in drug users in Jiangsu is 1b,and then comes the mixed infection of 1b/2a,and they are typically distributed between the North and South of China.